The impact of the HHS and DEA expansion of prescriptions for OUD

The HHS and DEA introduced new rules to expand telemedicine prescribing of controlled substances, including a final rule allowing practitioners to prescribe up to a six-month supply of certain medications for opioid use disorder by audio-only telemedicine.

What happened 

On January 15, 2025, the Department of Health and Human Services (HHS) and the Drug Enforcement Administration (DEA) announced a series of regulatory updates to expand telemedicine prescribing of controlled substances. The DEA proposed a special registration rule, which outlines three types of registration waivers to bypass in-person visit requirements for telemedicine prescribing and a state registration requirement for each state where the provider treats patients. Providers must apply for these registrations, and the DEA proposes a three-year review of the nationwide Prescription Drug Monitoring Program (PDMPs). Public comments for the proposed rule are due by March 15, 2025. 

The main takeaways 

• Practitioners can now prescribe up to a six-month supply of Schedule III-V medications for opioid use disorder via audio-only telemedicine.
• Additional prescriptions can be issued through video telemedicine or after an in-person evaluation.
• The DEA requires practitioners to review the PDMP to determine the patient’s state before prescribing.
• A proposed rule introduces special registrations to waive in-person visit requirements for prescribing controlled substances via telemedicine.
• Providers with special registrations must apply for each state where they treat patients and review nationwide PDMP data every three years.
• The new rules aim to maintain care access and safeguard against controlled substance misuse.

Related: Telehealth and therapy: A guide

How it will impact telemedicine services 

While the rule aims to maintain patient safety and prevent misuse of medications, it imposes restrictions such as requiring in-person evaluations for prescription renewals beyond an initial 30-day supply of certain controlled substances. The shift may create barriers for patients who rely on telemedicine services, particularly those in remote or underserved areas, as they may now face challenges in obtaining necessary medications without an in-person visit. 

Consequently, healthcare organizations will need to adapt their telemedicine workflows and ensure compliance with these new rules. This could strain resources and limit the flexibility that telemedicine has offered in recent years. 

Related: HIPAA Compliant Email: The Definitive Guide 

Potential to increase access and decrease substance abuse

Allowing healthcare providers to prescribe buprenorphine via telemedicine enhances access to essential treatment for individuals facing barriers to care. It is particularly beneficial in rural or underserved areas where access to addiction specialists is limited. The convenience of telemedicine eliminates the need for patients to travel long distances reducing logistical hurdles that can prevent them from seeking help.

The final rule also allows for regular check-ins and follow-up appointments to monitor patient progress and adjust treatment plans as necessary. Continuous engagement can help prevent relapse and support recovery efforts, ultimately contributing to lower rates of substance abuse.

Through the prescribing process for buprenorphine, the rule encourages more healthcare providers to become involved in treating opioid use disorder. The increase in available providers can help normalize the conversation around addiction treatment and reduce the stigma associated with seeking help. As more practitioners offer these services, patients may feel more comfortable accessing care.

FAQs

What technology is needed for a telemedicine visit?

To participate in a telemedicine visit, patients need a device capable of real-time audio and video communication, such as a smartphone, tablet, or computer, along with a reliable internet connection.

Can patients have a telemedicine appointment with a provider they have never seen before?

Yes, regulations have been adjusted to allow new patients to have telemedicine visits with providers, expanding access to care for individuals who may not have an established relationship with a healthcare provider.

What types of medical services can be provided through telemedicine?

Telemedicine can be used for various medical services, including follow-up visits, consultations for chronic conditions, mental health services, and some specialty care, though certain conditions may still require in-person evaluations.